Primarily to diagnose and monitor acute pancreatitis; also sometimes to diagnose and monitor chronic pancreatitis or other pancreatic diseases
Lipase
When you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea
A blood sample drawn from a vein in your arm
None
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How is it used?
The blood test for lipase is most often used, along with an amylase test, to help diagnose and monitor acute pancreatitis. It may also be used to diagnose and monitor chronic pancreatitis and other disorders that involve the pancreas but is not as useful of a test for these conditions because lipase levels remain elevated for longer periods and may not reveal clinical progress.
Lipase testing is also occasionally used in the diagnosis and follow-up of cystic fibrosis, celiac disease, and Crohn disease.
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When is it ordered?
A lipase test may be ordered when a person has symptoms of acute pancreatitis or another pancreatic disorder, such as:
- Severe abdominal or back pain
- Fever
- Loss of appetite
- Nausea
It may also be ordered at intervals when a health practitioner wants to monitor someone with a pancreatic condition to evaluate the effectiveness of treatment and to determine whether the lipase levels are increasing or decreasing over time.
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What does the test result mean?
A high lipase level in the blood may indicate the presence of a condition affecting the pancreas.
In acute pancreatitis, lipase levels are frequently very high, often 5 to 10 times higher than the highest reference value (often called the upper limit of normal). Lipase concentrations typically rise within 4 to 8 hours of an acute pancreatic attack and remain elevated for up to 7 to 14 days. Lipase levels cannot be used to determine the severity of an acute pancreatic attack.
Concentrations may also be increased with pancreatic duct obstruction, pancreatic cancer, and other pancreatic diseases as well as with gallbladder inflammation or kidney disease.
A low level of lipase in the blood may indicate permanent damage to the lipase-producing cells in the pancreas. This can occur in chronic diseases that affect the pancreas such as cystic fibrosis.
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Is there anything else I should know?
When acute pancreatitis occurs, lipase levels usually rise in about the same time as blood amylase concentrations, about 4-8 hours, but lipase levels will remain elevated longer than amylase levels. Lipase testing is thought to be more reliable than amylase testing for the initial diagnosis of acute pancreatitis and is also more sensitive to detecting acute pancreatitis caused by alcohol consumption.
Drugs that may increase lipase levels include pain medications like codeine, indomethacin, and morphine, birth control pills, thiazide diuretics, and cholinergic drugs, among others.
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What are the long-term consequences of pancreatitis?
With acute pancreatitis, there is usually no long-term damage and often no further problems develop. Chronic pancreatitis, which may present as a series of acute attacks or as an ongoing upset, can cause permanent damage. As the pancreas becomes scarred, some people develop diabetes and/or the inability to digest foods, especially fats. The lack of normal pancreatic enzymes may lead to adverse effects on food digestion and waste production, causing malabsorption, abdominal pain, greasy stools, and the formation of stones in the pancreas. Even if the disease is controlled, the damage is often irreversible. If the disease progresses, it could lead to death.
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Do elevated lipase levels always mean I have a pancreatic condition?
In some cases, an elevated lipase level may be due to a condition other than pancreatitis. In pancreatitis, the lipase level rises quickly and drops in 7 to 14 days. In other conditions, the rise is usually not as great and the level may be maintained for a longer period. Moderately increased lipase values can occur in other conditions, such as kidney disease, and may also be due to decreased clearance from the blood, salivary gland inflammation, gallbladder inflammation, celiac disease, a bowel obstruction, or peptic ulcer disease. The lipase test is not, however, usually used to monitor these conditions. Your health practitioner will determine whether you have a pancreatic disorder and will make a diagnosis based on your symptoms, medical history, and test results.
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Why might lipase and amylase tests be ordered together?
Blood amylase tests are sensitive for pancreatic disorders but are not specific for the disorders. That means an elevated amylase level may indicate a problem, but a disorder unrelated to the pancreas may be the cause. Lipase tests are usually more specific than amylase for diseases of the pancreas, particularly for acute pancreatitis and for acute alcoholic pancreatitis. Evaluating the results of the two tests together helps to diagnose or rule out pancreatitis and other conditions.